Chlorambucil for IBD

Hello, I have a 13 year old male kitty that was recently diagnosed, through biopsy, with small intestine IBD. He is currently on prednisolone once daily and has only gained back 1/2 lb. The vet wants him to gain at least another pound or two. He eats really well, at least 1-1.5 cans (6oz size) per day and his vomiting has ceased. She said that if he has not gained any more by his next visit in November, she wants to try him on a light dose of chlorambucil (Leukeran) once every two weeks. Perhaps it will decrease more of the inflammation and hopefully he can gain  weight. Has anyone used this with their kitty and any significant bad side effects? Also, do you really have to avoid touching their saliva for 24 hours after dosing? My cat kisses me and rubs his face on my arm or face a lot, he likes affection.

thanks for any help.

I think more and more vets have started using Leukeran for IBD in conjunction with the Prednisolone.  You have until November to make a decision.  Is your kitty getting B12 injections?  They often help with absorption issues.

There can be side effects, it is strong enough to be classified as a chemo drug.  The only way to know how it will affect your kitty  is to try it.  Hopefully your kitty will pick up some weight before November.  How long has he been on the Pred?  

purcy said:

 
Hello, I have a 13 year old male kitty that was recently diagnosed, through biopsy, with small intestine IBD. He is currently on prednisolone once daily and has only gained back 1/2 lb. The vet wants him to gain at least another pound or two. He eats really well, at least 1-1.5 cans (6oz size) per day and his vomiting has ceased. She said that if he has not gained any more by his next visit in November, she wants to try him on a light dose of chlorambucil (Leukeran) once every two weeks. Perhaps it will decrease more of the inflammation and hopefully he can gain  weight. Has anyone used this with their kitty and any significant bad side effects? Also, do you really have to avoid touching their saliva for 24 hours after dosing? My cat kisses me and rubs his face on my arm or face a lot, he likes affection.

thanks for any help.

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I've never heard of Leukeran being given every two weeks, but perhaps that could help.  Usually its every other day, and i think you probably don't have to worry about your cat's saliva but if you are, put the pill inside a pill pocket and pill him that way even if you have to force it in, that way the pill doesn't touch the inside of the mouth.  Obviously you will be wearing gloves when doing this.

What dose of Pred is your cat on?

Good luck!

Denice said:

 
I think more and more vets have started using Leukeran for IBD in conjunction with the Prednisolone.  You have until November to make a decision.  Is your kitty getting B12 injections?  They often help with absorption issues.

There can be side effects, it is strong enough to be classified as a chemo drug.  The only way to know how it will affect your kitty  is to try it.  Hopefully your kitty will pick up some weight before November.  How long has he been on the Pred?  Helo

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Hello, thank you. He was on B12 injections but his cobalamin level is perfect so I don't give them anymore. He has been on Prednisolone for mabye 7 or 8 weeks. 

StephenQ said:

 
I've never heard of Leukeran being given every two weeks, but perhaps that could help.  Usually its every other day, and i think you probably don't have to worry about your cat's saliva but if you are, put the pill inside a pill pocket and pill him that way even if you have to force it in, that way the pill doesn't touch the inside of the mouth.  Obviously you will be wearing gloves when doing this.

What dose of Pred is your cat on?

Good luck!

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I think maybe the vet is wanting to start on a low doseage with the every two weeks thing and then it can be increased to maybe weekly if needed. I have heard of some cats not eating the day after dosing which would worry me about an every other day doseage, wouldn't they just never want to eat? He takes 7.5 mg of Prednisolone daily. thank you!

purcy said:

 
I think maybe the vet is wanting to start on a low doseage with the every two weeks thing and then it can be increased to maybe weekly if needed. I have heard of some cats not eating the day after dosing which would worry me about an every other day doseage, wouldn't they just never want to eat? He takes 7.5 mg of Prednisolone daily. thank you!

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About 20% of cats have bad reactions including nausea and diarrhea.  Good luck!

StephenQ said:

 
About 20% of cats have bad reactions including nausea and diarrhea.  Good luck!

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oh no. thank you for your reply. I am very nervous to have him try it.

purcy said:

 
oh no. thank you for your reply. I am very nervous to have him try it.

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Well the upside is that 80% of cats tolerate it well enough to continue.  But if your cat is one of the unlucky ones, and he gets worse diarrhea or vomiting, then you stop giving it.

StephenQ said:

 
Well the upside is that 80% of cats tolerate it well enough to continue.  But if your cat is one of the unlucky ones, and he gets worse diarrhea or vomiting, then you stop giving it.

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thank you. Well he has no diarrhea or vomiting right now. He did have frequent vomiting, almost everyday, but since being on the steroids his vomiting is down to like once or twice a month, and they are hairballs. I'm pretty happy about that, and he eats a lot more too. 1.5 cans (6oz size) of food a day.

purcy said:

 
thank you. Well he has no diarrhea or vomiting right now. He did have frequent vomiting, almost everyday, but since being on the steroids his vomiting is down to like once or twice a month, and they are hairballs. I'm pretty happy about that, and he eats a lot more too. 1.5 cans (6oz size) of food a day.

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That's great news, please keep us updated.

StephenQ said:

 
That's great news, please keep us updated.

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I will, thank you. He got down to 7 lbs, from his life long high of 9.5 lbs. The vet wants him to gain back 1-2lbs, and so far he's only gained 1/2 lb in 6 weeks on the steroids. hoping for a gradual weight gain, but he is active, happy and eating with just the steroids and I am very concerned with adding anything and perhaps having a bad reaction. thank you for your replies.

purcy said:

 
I will, thank you. He got down to 7 lbs, from his life long high of 9.5 lbs. The vet wants him to gain back 1-2lbs, and so far he's only gained 1/2 lb in 6 weeks on the steroids. hoping for a gradual weight gain, but he is active, happy and eating with just the steroids and I am very concerned with adding anything and perhaps having a bad reaction. thank you for your replies.

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1/2lb in 6 weeks is not fast enough to be in a quality remission.....maybe your vet would be willing to go up to 10mg a day?

StephenQ said:

 
1/2lb in 6 weeks is not fast enough to be in a quality remission.....maybe your vet would be willing to go up to 10mg a day?

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I already asked her, she said it is dosed at 1 mg per pound of body weight and any more could cause muscle wasting. I know what to think. We don't have any other specialists in my area

Hi Purcy.I'm glad your baby has gained some weight.i can shed some light into chlorambucil.Normal dosing & I don't know if you are dealing with a vet or specialist.Normal dosing of chlorambucil is usually 1-( 2mg) tab every second day.Mine were to be kept in the fridge.Now there is pulse dosing of leukeran(chlorambucil) as well.

Here is a snippet from the lymphoma group i belong to who has a Dr.Of veterinary internal Medicine who volunteers precious time for answers.He currently has 40 cats in his practice on pulsed dosing.

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"This disease typically does not require frequent hospital visits. The chemo can be relatively inexpensive if you go with the every 2 week pulse dosing and buy a couple months of medication at a time. 

The Prednisolone should be daily. Vitamin B-12 levels should be checked or it should be supplemented since about 70% of small cell intestinal lymphoma cats are deficient. 

Antinausea medications may or may not be needed. Ondansetron is less expensive an probably more effective than Cerenia."

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Pulsed dosing is fairly new and a lot of Dr's do not know of it.I can tell you about food though & weight gain.My boy Maxwell I was syringe feeding for 3 months steady.To give you an idea of calorie intake.He weighed 7lbs.I was syringing him 9-12, 25cc syringes of Iams max Cal Vet canned food which was 330 calories per tuna size can per day.So he was roughly getting about give or take 400 calories per day.Alot but he was a trooper and tolerated syringe feeding very well.In three months he gained 3.8 lbs.So you can see how long it does take. His pred dose was the same as you are ding.2.5mg tid

I only dealt with an Internist not a veterinarian as I found her far superior to any vet I had ever had.You may want to ask your vet about pulsed dosing if he/she feels it might benefit your kitty.You have weight gain and although to us is seems small it is HUGE.As they can slide the other way within days.

Note**** I a not a Vet but do belong to two differnt yahoo groups One dealing with the lymphoma Who has Dr.Olson & the other just feline cancer group @ yahoo.Did anyone mention lysine being supplemented to your kitty during this protocol? If not you may want to join the feline lymphoma group posting New Member Att: Dr.Olson  and ask him his thoughts.I see you only have one specialist.That is hard.But at least you are dealing with one.Maybe run this all by your specialist but do be glad that there is weight gain.It is all about fat content of food which was 14% with the Iams and lot's of it.But it does have to stay down.Usually anti nausea meds are supplemented.

Cats that are nauseous most are NOT vomiting.People assume they have to be vomiting.This is NOT true at all.If you would like to join and ask Dr.Olson here is the link.Pls make your posting huge as this is a very high volume group & you need to get his attention.He has been an Internist for 27 years in georgia.HTH Honey.he may be able to consult with your specialist as he is doing it all the time.*******Please run this all by your veterinarian or specialist your are currently working with..********..

Their link is  https://groups.yahoo.com/neo/groups/feline_lymphoma/info

Hi Purcy.

I wanted to say that a lot of Vets,IM vets,oncologists will not trat IBd with leukeran.But not all and have read many times of members of the IBD group when all else failed their specialist went that route.Dr.Olson may not deal with IBD as per dosing Leukeran.I don't know.I do know he does do pulse dosing but these kitties he is dealing with have cancer.Great you had the biopsy & great the B12 is on the mark.You are doing everything right in my books.Leukeran is a very powerful drug but can help with IBD severe cases.Pred you would not want your kitty to be on high doses forever.The IBD group i belong to @ yahoo have their kitts on pred but do their best as per their advice from their vet to try to keep it as low as possible.They would probably be more of an insight on what they have done and if your vet which to me sounds like on the ball.It does help with inflammation.But only an assumption not to go as high as treating cancer I think would be true.But I am not a vet.I have never heard of cat's saliva being a problem but handling with gloves(The pill) was recommended.You may want to join the IBD group as that is truly what you are dealing with.What kind of calories per day is your kitty getting into him/her?Wellness Core canned grain free hold over 200 calories per can.So you do want higher calorie food.But no food is good as long as kitty doesn't eat enough of it.Great the diarrhea has stopped & vomiting.If you go to www.catinfo.org Dr.Pierson has a huge lists of foods and their calories &etc.You definitely want something high in calories.Here is the link to the IBD if you think the members there who may be supplementing leukeran as well as per their vet's recommendations & food etc.I think you're doing a great job!Here is the IBD group's link    https://groups.yahoo.com/neo/groups/felineibd1/info  HTH & keep up the great work!!!Hugs C.

Thank you so much for all of your information and replies. I am seeing an Internal Medicine specialist. My cat is eating very well, daily he eats about 9 oz of canned Instinct (rabbit or duck or salmon) I believe the calories are very adequate as it is a very high protein source. She definitely said she would like to do 4 mg (2 capsules) of chlorambucil every two weeks. I can get it compounded at a pharmacy for very affordable price. She said he would also remain on the 7.5mg of prednisolone daily. I will wait to see what his hopeful weight gain is in November at his checkup. He certainly is not losing any weight, he feels heavier and is wider. He just acts so happy and has a good quality of life, I want as little meds as possible, he is a fighter a pill time.

Hi Purcy.That's who i dealt with was a board Certified Internist.Her knowledge was superb!! The Kcal may be on the food your are giving.Which is the calories.if not usually there is a 1-800# to call or online googling the company.It does take calories to gain weight.Quite a few actually.like i said my 8lb boy was getting approx 350-400 calories per day.To gain weight.Average kitty being 10 lbs eats roughly 180-200 calories per day to keep their weight.Not gain.You're doing everything super.What a lucky baby to have a Mom like You!!! Keep up the great work & Hugs to the little one. C.

MomofMaxwell said:

 
Hi Purcy.That's who i dealt with was a board Certified Internist.Her knowledge was superb!! The Kcal may be on the food your are giving.Which is the calories.if not usually there is a 1-800# to call or online googling the company.It does take calories to gain weight.Quite a few actually.like i said my 8lb boy was getting approx 350-400 calories per day.To gain weight.Average kitty being 10 lbs eats roughly 180-200 calories per day to keep their weight.Not gain.You're doing everything super.What a lucky baby to have a Mom like You!!! Keep up the great work & Hugs to the little one.

C.

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ohhh. I just checked online for the calories on the Instinct canned that he eats, and for instance, the Salmon one has 185 metabolizable calories per can, so he gets maybe 270 calories per day?? so what is the name of the high calories supplement you were feeding your baby? I may need to add that perhaps.

and thank you so  much for your compliments. I am trying everything I can, he is my entire world

MomofMaxwell said:

 
Hi Purcy.That's who i dealt with was a board Certified Internist.Her knowledge was superb!! The Kcal may be on the food your are giving.Which is the calories.if not usually there is a 1-800# to call or online googling the company.It does take calories to gain weight.Quite a few actually.like i said my 8lb boy was getting approx 350-400 calories per day.To gain weight.Average kitty being 10 lbs eats roughly 180-200 calories per day to keep their weight.Not gain.You're doing everything super.What a lucky baby to have a Mom like You!!! Keep up the great work & Hugs to the little one.

C.

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oh I see you fed the Iams Max calorie food. I just checked that out and it has chicken. Darn, Purcy has a big poultry allergy for years, which is why he only eats rabbit, duck and salmon. I'll see if I can find an alternate protein Max Calorie food

Hi Purcy.

Sorry for the late reply.Yes you are dealing with novel proteins so gets a little trickier.have you heard of bonito flakes?They are found at an asian grocery store.Fish flakes mostly used to entice kitties to eat.What happens if you provide your baby more food at a time?Does he/she just walk away when full or??Is this canned form you are feeding? Do they make a dry of the same brand etc only in dry possibly? I understand about novel proteins as i read about them all the time on the IBD group.Just wondered how your feeding schedule worked in a day.Do you feed your babe like 3 x a day or?? Do you go out to work possibly then come home & feed more or what is the actual feeding schedule you have going right now?How about turkey is that an allergen too?Wellness core Grain Free turkey is 230 I think calories per can.But you wanna make sure no allergies to that either.Probably as i was told Duck by my Internist as a no go it's too close tot he poultry family she said.Even pheasant is too.You don't need to go backwards.You are doing so well!! Do you leave anything overnight for babe? Do they make dehydrated rabbit chunks like they do with chicken & turkey?That may be a possibility to check out.Here are a couple of blogs of members using rabbit.You may be already using one of these already, but thought I'd throw them out there for you in case.HTH C

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She eats a combo of Nature's Variety Rabbit (canned and LID kibble), and Royal Canin Prescription Rabbit (canned)

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Rockstar Rabbit is made by Instinct.  Petco carries it if you have a local store, otherwise most online pet food stores carry it by the case.  Rockstar Rabbit is flaked, and Ritzy Rabbit is minced.  I think they are basically the same recipe, just a little different texture.

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Purcy I did google rabbit treats for cats.There are a lot of different ones.You can google & see if anything catches your eye.You wouldn't want to go crazy obviously but???